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Individuals between the ages of 15-29 represent nearly half of all new sexually transmitted infections (STIs). If untreated, STIs can lead to serious and long-term health effects. A large portion of young people in this age group are enrolled in college. African American college students are disproportionately impacted by high rates of STIs, including HIV. The study explores a new biomedical HIV prevention method, pre-exposure prophylaxis (PrEP). PrEP is a daily pill used to prevent new HIV infections for individuals that are HIV-negative. This study generates new knowledge about an Historically Black College/University students’ knowledge, willingness, acceptability, feasibility, barriers and facilitators to the uptake of PrEP.
Methods:
A qualitative study was used to assess the knowledge, accessibility, feasibility, and barriers to taking PrEP for students attending an HBCU in the Southern U.S. We recruited undergraduate and graduate students who were enrolled in 2017 and who self-identified as heterosexual, men who have sex with men, or transgender to participate in groups (8). Trained research assistants recruited students via campus events, student organizations, and we used email announcements and campus flyers. The focus groups used a semi-structured interview guide to understand their perceptions and knowledge of HIV and PrEP, the uptake of PrEP, and culturally appropriate ways to introduce new biomedical HIV prevention methods to students. Each focus group was comprised of 8-10 students and lasted 60–90 minutes. Ground theory was used for qualitative analysis by using Dedoose. Interview transcripts were analyzed using a comprehensive coding process. The first reading was (1) deductive and allowed coders to read and capture participants’ answers to individual questions and (2) the second review looked for themes in the text, employed an “open coding” process, and themes were grouped according to topics that arose during the focus groups. Double-coded transcripts were reviewed for concordance, discrepancies were discussed, and resolved among data analysts; which contributed to the reliability and validity of the study findings.
Results:
Most students were unfamiliar with PrEP, but were genuinely interested to learn of new means of HIV prevention. Students indicated an interest in taking PrEP, but some were concerned about the stigma associated with HIV and PrEP. Barriers to taking PrEP include access to the medication, insurance, and concerns their parent’s insurance company may reveal that they were prescribed PrEP.
Conclusions and Implications:
There is a need to develop PrEP health literacy campaigns for college age students attending HBCUs and other institutions. There is a dearth of PrEP research focusing on this population, which could contribute new HIV infections among this age group. The study has shown the importance for better health information accountability among insurances companies and policies that protect students’ privacy. Future research should include HBCU students in PrEP clinical trials.